LEGISLATION/GUIDANCE RELEVANT TO ACTIVITY 2

From a HSE document - an extract from their Sector Information Minute -

to HSE Inspectors RE: Public Sector Programme 06/07: MSD IN THE HEALTH SERVICES

RISK MANAGEMENT SYSTEM

20. Inspectors are asked to assess compliance with the following legislative requirements:

a.  Health & Safety at Work Act 74(HSW Act) s.2 and 3, Management of Health & Safety at Work Regulations 99 (MHSWR) reg.5: a manual handling policy, and other arrangements have been drawn up, which are relevant, up to date and clearly understood by employees at ward/department level;

b.  Manual Handling Operations Regulations (MHOR) reg.4, MHSWR reg.5, Display Screen Equipment Regs (DSE) reg.2: risk assessments, for load and/or patient handing operations or for ultrasound-workstations where relevant, have been carried out by a competent person with the involvement of local staff or their representatives. All staff likely to be engaged in these tasks should be aware of the findings of these assessments and be able to explain the practical implications;

c.  MHSWR reg.7: the employer has access to competent advice, e.g. a back care or manual handling co-ordinator or via other specialist advice arrangements. They should advise on the management of all MSD issues including patient handling, risk assessment, inanimate load handling, design of tasks, selection and purchasing of equipment and training. The adviser should be an integrated part of the overall risk management team and work closely with occupational health, tissue viability and infection control specialists. The adviser should also be able to assist with investigation of accidents and incidents;

d.  MHOR reg.4, (see para 80, HSE publication L23 Guide to Regulations, MHOR 1992 as amended): moving and handling aids are provided, are suitable for the task, properly maintained, and where appropriate, have undergone a thorough examination and test; Thorough examination should extend to slings and other accessories though the Trust should have sufficient competence to undertake this themselves;

e.  MHSWR regs.3 and 10, MHOR Reg 4, HSW Act s.2 and 3: the lifting/moving needs of individual patients/residents have been assessed and the significant findings recorded. Staff on the ward should have easy access to the information, and be able to demonstrate that any equipment identified as part of the risk assessment, e.g. a special sling, is readily available. Assessments should identify the level of support/ equipment necessary for each handling task e.g. transfer from bed to chair, toileting;

f.  MHOR reg.4, MHSWR reg.13: no staff should undertake manual handling operations, or use lifting aids, until they have been trained and assessed as competent. Employers should be taking particular care, when using bank and agency staff, to ensure they are competent in patient-handling theory and practice plus any specific training as required by the Trust’s policies and procedures e.g. moving and handling of children.

21. Inspectors should also enquire about arrangements for active case management of staff who suffer work-related MSDs. This should aim to ensure that they are able to remain in work where possible. Where this is not possible, there are properly planned, managed and monitored arrangements for their phased return to work either to the same job, or if necessary, redeployment. Guidance is contained in IND (G) 333, Back in Work.

HEALTH AND SAFETY AT WORK ACT 1974

SECTION 2. GENERAL DUTIES OF EMPLOYERS TO THEIR EMPLOYEES

(1) It shall be the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all his employees.

(2) Without prejudice to the generality of an employer’s duty under the preceding subsection, the matters to which that duty extends include in particular—

a)  the provision and maintenance of plant and systems of work that are, so far as is reasonably practicable, safe and without risks to health;

b)  arrangements for ensuring, so far as is reasonably practicable, safety and absence of risks to health in connection with the use, handling, storage and transport of articles and substances;

c)  the provision of such information, instruction, training and supervision as is necessary to ensure, so far as is reasonably practicable, the health and safety at work of his employees;

d)  so far as is reasonably practicable as regards any place of work under the employer’s control, the maintenance of it in a condition that is safe and without risks to health and the provision and maintenance of means of access to and egress from it that are safe and without such risks;

e)  the provision and maintenance of a working environment for his employees that is, so far as is reasonably practicable, safe, without risks to health, and adequate as regards facilities and arrangements for their welfare at work.

(3) Except in such cases as may be prescribed, it shall be the duty of every employer to prepare and as often as may be appropriate revise a written statement of his general policy with respect to the health and safety at work of his employees and the organisation and arrangements for the time being in force for carrying out that policy, and to bring the statement and any revision of it to the notice of all of his employees.

(4) Regulations made by the Secretary of State may provide for the appointment in prescribed cases by recognised trade unions (within the meaning of the regulations) of safety representatives from amongst the employees, and those representatives shall represent the employees in consultations with the employers under subsection (6) below and shall have such other functions as may be prescribed.

(5) Regulations made by the Secretary of State may provide for the election in prescribed cases by employees of safety representatives from amongst the employees, and those representatives shall represent the employees in consultations with the employees under subsection (6) below and may have such other functions as may be prescribed.

(6) It shall be the duty of every employer to consult any such representatives with a view to the making and maintenance of arrangements which will enable him and his employees to co-operate effectively in promoting and developing measures to ensure the health and safety at work of the employees, and in checking the effectiveness of such measures.

(7) In such cases as may be prescribed it shall be the duty of every employer, if requested to do so by the safety representatives mentioned in [F2 subsection (4)] above, to establish, in accordance with regulations made by the Secretary of State, a safety committee having the function of keeping under review the measures taken to ensure the health and safety at work of his employees and such other functions as may be prescribed.

SECTION 3. GENERAL DUTIES OF EMPLOYERS AND SELF-EMPLOYED TO PERSONS OTHER THAN THEIR EMPLOYEES

(1) It shall be the duty of every employer to conduct his undertaking in such a way as to ensure, so far as is reasonably practicable, that persons not in his employment who may be affected thereby are not thereby exposed to risks to their health or safety.

(2) It shall be the duty of every self-employed person to conduct his undertaking in such a way as to ensure, so far as is reasonably practicable, that he and other persons (not being his employees) who may be affected thereby are not thereby exposed to risks to their health or safety.

(3) In such cases as may be prescribed, it shall be the duty of every employer and every self-employed person, in the prescribed circumstances and in the prescribed manner, to give to persons (not being his employees) who may be affected by the way in which he conducts his undertaking the prescribed information about such aspects of the way in which he conducts his undertaking as might affect their health or safety.

Management of Health and Safety at Work Regulations 1999

Regulation 3 Risk assessment

(1) Every employer shall make a suitable and sufficient assessment of-

(a) the risks to the health and safety of his employees to which they are exposed whilst they are at work; and

(b) the risks to the health and safety of persons not in his employment arising out of or in connection with the conduct by him of his undertaking,

for the purpose of identifying the measures he needs to take to comply with the requirements and prohibitions imposed upon him by or under the relevant statutory provisions and by Part II of the Fire Precautions (Workplace) Regulations 1997.

(2) Every self-employed person shall make a suitable and sufficient assessment of-

(a) the risks to his own health and safety to which he is exposed whilst he is at work; and

(b) the risks to the health and safety of persons not in his employment arising out of or in connection with the conduct by him of his undertaking,

for the purpose of identifying the measures he needs to take to comply with the requirements and prohibitions imposed upon him by or under the relevant statutory provisions.

(3) Any assessment such as is referred to in paragraph (1) or (2) shall be reviewed by the employer or self-employed person who made it if-

(a) there is reason to suspect that it is no longer valid; or

(b) there has been a significant change in the matters to which it relates; and where as a result of any such review changes to an assessment are required, the employer or self-employed person concerned shall make them.

(4) An employer shall not employ a young person unless he has, in relation to risks to the health and safety of young persons, made or reviewed an assessment in accordance with paragraphs (1) and (5).

(5) In making or reviewing the assessment, an employer who employs or is to employ a young person shall take particular account of-

(a) the inexperience, lack of awareness of risks and immaturity of young persons;

(b) the fitting-out and layout of the workplace and the workstation;

(c) the nature, degree and duration of exposure to physical, biological and chemical agents;

(d) the form, range, and use of work equipment and the way in which it is handled;

(e) the organisation of processes and activities;

(f) the extent of the health and safety training provided or to be provided to young persons; and

(g) risks from agents, processes and work listed in the Annex to Council Directive 94/33/EC(a) on the protection of young people at work.

(6) Where the employer employs five or more employees, he shall record-

(a) the significant findings of the assessment; and

(b) any group of his employees identified by it as being especially at risk

ACOP

General principles and purpose of risk assessment

9) This regulation requires all employers and self-employed people to assess the risks to workers and any others who may be affected by their work or business. This will enable them to identify the measures they need to take to comply with health and safety law. All employers should carry out a systematic general examination of the effect of their undertaking, their work activities and the condition of the premises. Those who employ five or more employees should record the significant findings of that risk assessment.

10) A risk assessment is carried out to identify the risks to health and safety to any person arising out of, or in connection with, work or the conduct of their undertaking. It should identify how the risks arise and how they impact on those affected. This information is needed to make decisions on how to manage those risks so that the decisions are made in an informed, rational and structured manner, and the action taken is proportionate.

11) A risk assessment should usually involve identifying the hazards present in any working environment or arising out of commercial activities and work activities, and evaluating the extent of the risks involved, taking into account existing precautions and their effectiveness. In this Approved

(a) a hazard is something with the potential to cause harm (this can include articles, substances, plant or machines, methods of work, the working environment and other aspects of work organisation);

(b) a risk is the likelihood of potential harm from that hazard being realised. The extent of the risk will depend on:

(i) the likelihood of that harm occurring;

(ii) the potential severity of that harm, ie of any resultant injury or adverse health effect; and

(iii) the population which might be affected by the hazard, ie the number of people who might be exposed.

12) The purpose of the risk assessment is to help the employer or self-employed person to determine what measures should be taken to comply with the employer’s or self-employed person’s duties under the ‘relevant statutory provisions’ and Part II of the Fire Regulations. This covers the general duties in the HSW Act and the requirements of Part II of the Fire Regulations and the more specific duties in the various acts and regulations (including these Regulations) associated with the HSW Act. Once the measures have been determined in this way, the duty to put them into effect will be defined in the statutory provisions. For example a risk assessment on machinery would be undertaken under these Regulations, but the Provision and Use of Work Equipment Regulations (PUWER 1998)9 determine what precautions must be carried out. A risk assessment carried out by a self-employed person in circumstances where he or she does not employ others does not have to take into account duties arising under Part II of the Fire Regulations.